Provider Demographics
NPI:1730514472
Name:RECKREY, LORIE MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:MARIE
Last Name:RECKREY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LORIE
Other - Middle Name:MARIE
Other - Last Name:RESKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:9250 GLENWOOD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1365
Mailing Address - Country:US
Mailing Address - Phone:913-648-8880
Mailing Address - Fax:913-648-8881
Practice Address - Street 1:9250 GLENWOOD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1365
Practice Address - Country:US
Practice Address - Phone:913-648-8880
Practice Address - Fax:913-648-8881
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76158363L00000X
MO2013033427363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111023009Medicare PIN
MOR28A00008Medicare PIN
KSR28000008Medicare PIN